Endoscopic Cholecystectomy: An Analysis of Complications

Bruce M. Wolfe, Barry N. Gardiner, Barbara F. Leary, Charles F. Frey

Research output: Contribution to journalArticlepeer-review

171 Scopus citations

Abstract

We analyzed our initial 381 endoscopic cholecystectomies with particular emphasis on postoperative complications. The rate of conversion to open cholecystectomy was 3%. A technical complication occurred in 2% and a nontechnical complication in 4%, for a total complication incidence of 6%. There were three postoperative fatalities (0.9%). Two fatal technical complications consisted of unrecognized intestinal injuries at the time of endoscopic cholecystectomy that were obvious when the abdomen was opened. One patient died of a cerebrovascular accident. Nonfatal technical complications included five bile leaks that required treatment. There were no common bile duct injuries, but excessive caution to prevent common bile duct injury may have contributed to the high incidence of bile leaks. Examination of the case numbers of the technical complications and conversion to open cholecystectomy suggests that the learning curve is real and somewhat prolonged, and that a willingness to convert to open cholecystectomy is necessary if technical complications are to be avoided.

Original languageEnglish (US)
Pages (from-to)1192-1198
Number of pages7
JournalArchives of Surgery
Volume126
Issue number10
DOIs
StatePublished - Oct 1991

ASJC Scopus subject areas

  • Surgery

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